Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.43 / $62.50 / $127.52	Professional		$47.43	$62.50	$127.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.51 / $24.27 / $59.75	Professional	26	$20.51	$24.27	$59.75
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.72 / $26.69 / $41.25	Professional	52	$23.72	$26.69	$41.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.58 / $32.58 / $72.31	Professional	TC	$26.58	$32.58	$72.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.84 / $65.84 / $65.84	Professional		$65.84	$65.84	$65.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $29.12 / $30.34 / $33.50	Professional	26	$29.12	$30.34	$33.50
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $41.58 / $41.58 / $41.58	Professional	TC	$41.58	$41.58	$41.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.00 / $73.15 / $126.85	Professional		$63.00	$73.15	$126.85
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.94 / $31.77 / $59.00	Professional	26	$23.94	$31.77	$59.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $36.34 / $44.00 / $77.48	Professional	TC	$36.34	$44.00	$77.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.88 / $75.20 / $149.80	Professional		$51.88	$75.20	$149.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $31.29 / $58.00	Professional	26	$22.91	$31.29	$58.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.91 / $43.76 / $96.18	Professional	TC	$29.91	$43.76	$96.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.37 / $72.31 / $137.25	Facility		$45.37	$72.31	$137.25
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $61.29 / $61.29 / $152.15	Facility	26	$61.29	$61.29	$152.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.77 / $73.05 / $396.63	Professional		$52.77	$73.05	$396.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.92 / $29.49 / $167.21	Professional	26	$19.92	$29.49	$167.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.90 / $45.15 / $257.11	Professional	TC	$29.90	$45.15	$257.11
United Facility/Professional Professional Modifier Low / Median / High Price $50.60 / $67.29 / $111.47	Professional		$50.60	$67.29	$111.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.92 / $28.01 / $52.03	Professional	26	$19.92	$28.01	$52.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.07 / $39.25 / $65.56	Professional	TC	$27.07	$39.25	$65.56